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Challenges of health education in the 21st century

Jaime Restrepo Cuartas1

1 Médico Cirujano de la Universidad de Antioquia. Actual Rector de la Universidad de Santander – UDES. Bucaramanga,Colombia. Autor de Correspondencia. E-mail:jaimeresc@gmail.comhttps://orcid.org/0000-0003-0079-7649

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Revista Cuidartehttp://dx.doi.org/10.15649/cuidarte.v9i3.611

Rev Cuid 2018; 9(3): 2291-3

How to cite this article: Restrepo JC. Desafíos de la educación en salud en el siglo XXI. Rev Cuid. 2018; 9(3): 2288-96. http://dx.doi.org/10.15649/cuidarte.v9i3.611

©2018 Universidad de Santander. Este es un artículo de acceso abierto, distribuido bajo los términos de la licencia Creative Commons Attribution (CC BY-NC 4.0), que permite el uso ilimitado, distribución y reproducción en cualquier medio, siempre que el autor original y la fuente sean debidamente citados.

“It is far more important to know what person the disease

has than what disease the person has” Hippocrates

The world of health education should keep pace with social development, at the risk of not reaching maturity but obsolescence. We are used to certain edu-cational models resulting to be traditional and we continue to cling to them as if nothing had happened. The University locks itself in its teaching-learning circles in the middle of an increasingly complex system, where everything changes surprisingly fast. Educational innovation should shake us up. The advantage that health programs have had is that education is patient-cente-red, that is, that practice exercise, a necessary element of comparison is not alien to the student of these disciplines from the first years, which gives them a competitive advantage over professions in which it is still considered that practice should be done at a later stage in the final year of their degrees.

To standardize processes within the traditional framework and to use techniques applicable to patients with specific algorithms, after many years of experience on the edge of the patient’s bed, the health education has opted to design “health care guidelines” or “clinical practice guidelines” that young professionals follow strictly, like following a manual, to search for good results; but these are not always the ex-pected ones, since they become into medicine challenges acting on more diseases but not on patients since the found evidence, which must supposedly be the same, results to be different.

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In this process, it is observed that many patients with the same disease do not respond in the same

-logies applied, even if these are used in patients whose evolutions should be similar. In addition to this, often surprisingly, it does not depend on

on the knowledge acquired through experience. It is possible that two female patients of similar age with a breast cancer detected at an early sta-ge, with the same trained surgeon and applying

ten years later, and the other may have died a few months after the treatment has been applied.

in Latin America to develop health promotion and disease prevention with the National School of Public Health, today a Faculty at the Univer-sidad de Antioquia and which provided succes-

in the countries neighboring Colombia such as Cuba, Chile, and Mexico, ended up not applying the model under the Law 100 of 1993 and turned health care into a welfare and hospital model, which despite being universal, is too costly and

diseases, many of them terminal diseases.

years have overcome these dynamics because the reasons why patients respond individually to the conditions and treatments they have undergone are better understood now. But we did not see that so clearly because of the enormous costs of drugs and the application of new technologies,

the panorama changes. Today, advanced research and top technology are the mainstays, which is why the era of the genomic revolution and perso-nalized medicine are starting now1.

In the development made in recent years, speci-

DNA genome sequencing (both nuclear and mi-

pathways and biological or bioinformatics infor-mation and phylogenetics have been determined. All this changes the concepts of microbiology, pharmacology, physiopathology, immunology, and epidemiology we had so far.

tumors with the advances so far. e.g. in the detec-tion of melanoma, prostate cancer, breast cancer, colon cancer or leukemia which obliges us to de-

something similar occurs in diseases that have

cardiopathies, or chronic obstructive pulmonary disease caused by tobacco. In daily life, there are asthmatics whose illness disappears sponta-neously, phenomena that can be observed with the existence or not of eosinophilia3, or chronic

one patient to another, for which it is established that it may be due to an inherent factor in the polymorphism of nucleotides.

Now remember that there is a new theoretical ba-sis in the knowledge of molecular mechanisms

Challenges of Health Education in the 21st Century

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in the entire health-disease process that obliges

therapeutic pathways, to approach pharmacology -

vidual responses, to observe both microbial and drug resistance, disease recurrences, the possibi-

expressions, and the current role of microorga-

Personalized medicine obliges us to establish a new health care model where the diagnosis is ac-companied by the genomic sequencing and the early detection of diseases through molecular markers; besides an inquiry into the environment in which the patient lives, which can also serve as predictive method to establish health promo-tion and disease prevention campaigns and the

the particularities of each individual, while sear-ching for a community and family approach ba-sed on the so-called 4Ps: Predictive, preventive, personalized, and participatory medicine4. This can lead us to a new way of health education.

Therefore, it is necessary to consider an approach that mixes the most advanced research in geno-mics and the application of advances with the use

of molecular markers to give precision to diag-nosis with predictive capacity and an emerging focus on primary care and family medicine on the disease prevention and management5, which determines the susceptibility of individuals, fa-milies, and communities, and then gains strength as never before in the teaching of genetics6, so -mething relatively neglected in health education today.

The author declare no

REFERENCES

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2. Li SG, Li LT. Targeted Therapy in Her2- positive breastcancer. Biomedical Reports. 2013; 1(4): 499-505.https://doi.org/10.3892/br.2013.95

3. Torre-Bouscoulet L. Los retos de la medicina personali-zada. Neumol. Cir. Tórax. 2015; 74(4): 238-9.

4. Hood L, Aufray C. Participatory medicine: a driving forrevolutionizing health care. Genome Med. 2013; 5(12):110. https://doi.org/10.1186/gm514

5. Von MFW, Sánchez VM. Medicina personalizada enatención primaria. Medicina de Familia. Sumergen. 2018;44(1): 1-2. https://doi.org/10.1016/j.semerg.2018.01.006

6. Dawes M, Aloise MN, Sidney JA, Cullis P, Dawes D,Fraser R, et al. Introducing pharmacogenetic testing withclinical decision support into primary care: A feasibilitystudy. CMAJ Open. 2016; 4(3): 528-34.https://doi.org/10.9778/cmajo.20150070

Jaime Restrepo Cuartas